P380 - IMPACT OF ARTIFICIAL INTELLIGENCE (AI)-ASSISTED MUSCLE MASS ASSESSMENT, NUTRITIONAL STATUS, AND SYSTEMIC INFLAMMATION ON OUTCOMES IN METASTATIC PANCREATIC CANCER: EVIDENCE FROM THE PANTHEIA–SPANISH SOCIETY OF MEDICAL ONCOLOGY (SEOM) STUDY

P380

IMPACT OF ARTIFICIAL INTELLIGENCE (AI)-ASSISTED MUSCLE MASS ASSESSMENT, NUTRITIONAL STATUS, AND SYSTEMIC INFLAMMATION ON OUTCOMES IN METASTATIC PANCREATIC CANCER: EVIDENCE FROM THE PANTHEIA–SPANISH SOCIETY OF MEDICAL ONCOLOGY (SEOM) STUDY

V. Pacheco-Barcia^1,*, F. X. Palmas Candia², R. Guerra³, A. Mariño Méndez⁴, E. Brozos⁵, M. L. Soriano⁶, R. Hernandez San Gil⁷, W. Parra⁸, L. Cabezon Gutierrez¹, P. Jimenez-Fonseca⁴

¹Medical Oncology, Hospital Universitario de Torrejon, Torrejon de Ardoz, ²Endocrinolgy, Hospital Universitario Vall d´Hebron, Barcelona, ³Instituto de Investigación de Microelectrónica Aplicada , Universidad Las Palmas de Gran Canaria, Las Palmas, ⁴Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, ⁵Medical Oncology, Complejo Hospitalario Universitario de A Coruña, A Coruña, ⁶Medical Oncology, Hospital La Candelaria, ⁷Medical Oncology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, ⁸Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain

Rationale: This study investigates baseline muscle mass, treatment-related muscle loss, and the roles of nutrition and inflammation in outcomes in metastatic pancreatic cancer (mPC).

Methods: 50 patients from the retrospective PANTHEIA–SEOM cohort. CT scans covering levels L1–L5 were analyzed using the FocusedON® AI software, which automatically segmented skeletal muscle. Muscle mass was quantified and normalized by height (kg/m²) and body surface area (BSA in kg/m²) to enable inter-individual comparisons. Comprehensive clinical and nutritional data were collected in PANDORA-SEOM platform, including oral nutritional supplement (ONS), serum albumin, and Nutriscore. SIRI was (neutrophils × monocytes) / lymphocytes: low (<2.3) or high (≥2.3).

Results: Median age 64.5 years, 42% male and 67% had ECOG PS 1. Lean muscle/BSA (<1.19 vs ≥1.19) differed significantly in males (69% vs 9%, p=0.005) and females (31% vs 91%, p=0.005). The median muscle mass change from diagnosis was -3.81% (IQR: -11.87 to 1.59). Patients with baseline lean muscle/BSA ≥1.19 showed higher survival rates (40% vs 7%, p=0.08) and median OS (15 vs 10 months, p=0.3) but experienced greater muscle loss (-9.92% vs 0.5%, p=0.03). They also had lower SIRI (1.98 vs 3.2, p=0.48). ONS were more frequent among those with higher muscle mass (60% vs 33%, p=0.2). No group differences emerged for Nutriscore ≥5. Among patients not on ONS, 75% lost ≥2.5% muscle mass vs 50% of those on ONS (p=0.6). Albumin <3.2 g/dL was linked to shorter survival (6 vs 15 months, p=0.3) and greater muscle loss (p=0.02).

Conclusion: Baseline muscle mass, its treatment-induced decline, and systemic inflammation impact survival in patients with mPC. Muscle monitoring and early nutritional interventions are pivotal to improve outcomes in mPC.

Disclosure of Interest: V. Pacheco-Barcia Other: Vilma Pacheco-Barcia: Advisory role: Advanced accelerator applications, a Novartis company, Nutricia. Speaker: Merck, Eli Lilly, Eisai, Pierre Fabre, Nutricia. Congress attendance: Merck, Amgen, Merck Sharp and Dhome, Nutricia. Grant support: FSEOM and Merck. Other: Amgen. Grant support: FSEOM, Merck and Pfizer. Research financial support: Nutricia, Pfizer, Servier and Leo Pharma. , F. X. Palmas Candia: None declared, R. Guerra: None declared, A. Mariño Méndez: None declared, E. Brozos Other: Amgen, Invited Speaker, Personal Astra Zeneca, Invited Speaker, Personal Bayer, Advisory Board, Personal BMS, Invited Speaker, Personal Kiowa Kirin, Invited Speaker, Personal LEO Pharma, Invited Speaker, Personal Merck, Invited Speaker, Personal MSD, Invited Speaker, Personal Pfizer, Advisory Board, Personal Roche, Invited Speaker, Personal Rovi, Invited Speaker, Personal Servier, Advisory Board, Personal Servier, Invited Speaker, Personal, M. L. Soriano: None declared, R. Hernandez San Gil: None declared, W. Parra: None declared, L. Cabezon Gutierrez Other: presentations of Roche, Astra Zeneca, Brystol Myers Squibb, Merck Serono, Ipsen Pharma, Grunenthal, Kyowa Kirin, Pfizer and Eisai and received support for attending meetings from Roche, Merck. Eli Lilly, Bristol-Myers Squibb and Nutricia. , P. Jimenez-Fonseca Other: honoraria for speakers' bureau participation, and serving on advisory boards from Astellas, AstraZeneca, Bristol-Myers Squibb (BMS), Esteve, LeoPharma, Merck Sharp & Dohme (MSD), Novartis, Nutricia, Pfizer, Rovi, Takeda, and Viatri and research grants from Astellas, AstraZeneca, BMS, and MSD.